Individual provider Active NPI

Charles Yang, DO

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1336720259
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB12106800 Issued in NJ
Practice address
1400 8TH Ave
Fort Worth, TX 76104-4110
Phone
(817) 926-2544
NPI assigned
Apr 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 25MB12106800 NJ Primary

Addresses

Primary practice location

1400 8TH Ave
Fort Worth, TX 76104-4110

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 793-0106

Other practice location 1

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (609) 206-4068

Other practice location 2

4000 Route 130
Delran, NJ 08075-2414
Phone (856) 705-0685

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NJExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630001117 TX Order and Referring Only - GastroenterologyPractitioner - Gastroenterology 0941745699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB12106800NJMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1336720259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-793-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-926-2544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 E Laurel Rd",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841327",
            "country_code": "US",
            "telephone_number": "609-206-4068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Route 130",
            "address_purpose": "LOCATION",
            "city": "Delran",
            "state": "NJ",
            "postal_code": "080752414",
            "country_code": "US",
            "telephone_number": "856-705-0685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YANG",
        "first_name": "CHARLES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB12106800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4000 Route 130",
            "city": "Delran",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080752414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.